Orthopedics Book


Long Thoracic Nerve Injury

Aka: Long Thoracic Nerve Injury
  1. See Also
    1. Peripheral Nerve Injury
  2. Causes
    1. Direct blow to Shoulder
    2. Chronic repetitive overhead Shoulder traction (e.g. tennis, swimming, baseball)
  3. Symptoms
    1. Diffuse Shoulder or Neck Pain with overhead activity
  4. Signs
    1. Forward flexion weakness at Shoulder
    2. Scapular winging
  5. Management
    1. Shoulder Range of Motion Exercises
      1. Prevents Frozen Shoulder and contractures
    2. Strengthen remaining Shoulder stabilizing muscles
      1. Trapezius Muscles
      2. Rhomboid Muscles
      3. Levator Scapula Muscle
    3. Surgery is rarely indicated
  6. Diagnostics
    1. Nerve Conduction Studies and EMG
    2. Shoulder MRI
      1. Not typically indicated but may show supraspinatus and infraspinatus denervation changes
  7. Course
    1. Therapy leads to recovery times typically of 9-12 months (may require up to 2 years)
  8. References
    1. Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
    2. Safran (2004) Am Sports Med 32(4): 1063-76 [PubMed]

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